Tendinopathies

This session included presentations on: The role of genetics in tendinopathy, tears and response to rehabilitation; When is a tendinopathy not an injury?; Injection therapies – what should we be using?; Biological versus clinical effects of ESWT; Current concepts in tendon loading; and An optimal multidisciplinary tendon clinic.

The main message from this session is that treatment for tendon pain is definitely not ‘one size fits all’. Although many of the risk factors for injury are multifactorial, genetic variants do modulate risk by contributing to normal biological variation. Additionally, not everything that looks like a tendon injury is an injury. It is important to treat the patient, not just the tendon, to be able to identify medical factors that may co-exist with tendon injury. Accurate diagnosis is important and ultrasound tissue characterisation (UTC) provides in-depth analysis of tendon tissue health. After discussion with the athlete, the most appropriate intervention and loading strategy should be chosen. Extracorpeal shock wave therapy is a management option for some tendinopathies if used appropriately. Research suggests that the contraction type is less important than the magnitude and speed of loading. Tendons need a 48-72 hour for adaption to heavy loads to promote protein synthesis.